Healthcare Provider Details

I. General information

NPI: 1952509267
Provider Name (Legal Business Name): COMPREHENSIVE HEALTH SERVICES LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3543 N 7TH ST
PHOENIX AZ
85014-5204
US

IV. Provider business mailing address

PO BOX 39179
PHOENIX AZ
85069-9179
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-8484
  • Fax:
Mailing address:
  • Phone: 602-395-0718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4257
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number133
License Number StateAZ

VIII. Authorized Official

Name: LESLIE DIGGES
Title or Position: DIRECTOR
Credential:
Phone: 602-308-7822